Development of an assessment tool for laparoscopic sigmoidectomy using the Delphi method

Several tools to assess surgeons' skills in laparoscopic surgeries have developed; nevertheless, the tools have not been developed to accommodate the Japanese guidelines and common surgical methods. Trainee surgeons would then not be able to learn the critical steps and important points of LCS procedures using the assessment tool. To fill the gap, we launched the “Development of an Assessment tool for Laparoscopic Colectomy” (ASLAC) project to develop a reliable tool to assess laparoscopic sigmoidectomy. The study consisted of two steps: cognitive task analysis (CTA) and application of the Delphi method. Consensus was defined in advance using Cronbach's alpha ≥0.8. Items for which 70% of experts cited a value of ≥4 (agree or strongly agree) were used as novel tool. Ten expert surgeons (considered “qualified surgeons” by the Endoscopic Surgical Skill Qualification System in Japan) were recruited. The mean number of years post-graduation was 26 (range, 19–32 years). The median number of LCS cases performed by the experts was 700 (range, 219–2700). Our scale consisted of 35 items. Cronbach's alphas of the 1st and 2nd rounds were calculated to be 0.85 and 0.81, respectively. All ten experts answered the first round and 20 items were excluded. The second round was answered by all experts and no items were deleted. Our new scale may be applicable in future clinical studies evaluating surgical skills in LCS.